The Australian Digital Health Agency (ADHA) is tasked by Australian Federal and State governments to lead the development and implementation of the National Digital Health Strategy. The Strategy focuses on four core themes; increasing access to useful medical information, creating a secure and trusted information network, supporting interoperability of data across the supply chain and fostering innovation .
Like many developed economies Australia is facing the challenge of reigning unsustainable growth in healthcare costs. In 2016 healthcare spending accounted for 9.6% of Australia’s GDP, having outgrown GDP by an average of 2-3 percentage points since 2000 . In response to growing cost pressures many organizations, both public and private, have leveraged digital innovations to reduce cost, save time and increase the quality of outcomes for patients.
The challenge which arises from increased digitalization of Australian Healthcare is one of co-ordination. If uncoordinated, such technology investments risk further dividing the industry and increasing transaction costs along the supply chain rather than reducing them. Failure to integrate data may further fragment the industry resulting in unnecessary duplication and errors. Furthermore, in an effort to extract competitive advantage, companies are incentivized to further silo their data, increasing switching costs for consumers and deepening silos between businesses .
Short term focus: Improving access to relevant patient data through My Health Records
In 2011-2012 the ADHA defined the technical vendor specifications for the Australian electronic medical record (EMR) system, My Health Records. This digital solution allows authorized healthcare providers to access patient information more effectively. 22% of Australians have a My Health Record .
Today the ADHA is responsible for ensuring every Australian has a My Health Record by the end of 2018. To do this the ADHA is actively educating patients and providers of the benefits and uses of EMRs. Furthermore, the ADHA established a Technical Working Group of industry stakeholders to develop a simplified and universal Secure Message Delivery (SMD) Program to enable organizations to securely share patient information. Coupled with standardize clinical terminology, these technologies improve data access and interoperability, providing authorized healthcare providers with the right information at the right time .
Providing secure access to patient data will enable more sophisticated healthcare data analytics. Technologies such as big data, artificial intelligence and machine learning will improve care coordination and reduce costs. Potential applications of these technologies include more personalized care, predictive diagnostics and improved chronic disease management .
Medium term focus: Laying the foundations for digital health innovation by 2022
To support sustained digital innovation the ADHA will roll out 6 “test bed” projects by 2022 which will be designed to rigorously test and validate the benefits of new digital technologies. These test beds are expected to focus on clinical priorities such as chronic diseases management, telehealth, aged care services, end of life care, childhood health and emergency care . Testing digital innovations in in a real-world environment will allow the ADHA to assess and refine each initiative before scaling nationally. This will support policy reform and validate alternative, sustainable and scalable models of care.
Further opportunities: The role of public-private partnerships in implementation
The greatest challenge facing the ADHA is that of implementation. The ADHA needs to work closely with the largest healthcare organizations to implement priority digital solutions. While it will be difficult to transition them across to digital, the early adoption by high volume hospitals for example, is critical to achieving scale and accelerating innovation. Third party vendors are less incentivized to build on top of the My Health Record system until sufficient scale is achieved.
Furthermore, many organizations have begun to independently invest in their own digital solutions. To minimize friction and increase participation, it is important that the ADHA works closely with these organizations. Cooperation will also facilitate learning and sharing of best practice from those organizations who have already invested in change. For example; Australia’s largest private hospital network, Ramsay Health Care, has deployed data standards for identifying, capturing and sharing information with suppliers, enabling them to save time and money through their procurement processes . Ramsay can play a critical role in informing industry standards as well as sharing best practice applications for delivering value.
Strong public-private partnerships will be critical. In 2016 the Parkville EMR project received $5M in funding from the state government to scope the needs of 3 major hospitals to introduce EMRs. A year later the project failed to secure funding for implementation and subsequently postponed indefinitely . Without funding support, large public hospital – the main providers of care to the majority of the population – will struggle to integrate digital solutions.
Questions for consideration
Is an EMR system a public good?
Should the public sector be leading digital innovation?
How can the ADHA mitigate implementation risk?
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